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NPI Code Detail

MEDICARE: LISA ELAINE MOCEK PT

MEDICARE: LISA ELAINE MOCEK PT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist1156525TX

General Provider Information

NPI Number : 1538269519
Entity Type Code : Individual
Provider Name (Legal Business Name) : LISA ELAINE MOCEK PT
Provider Business Mailing Address
First Line : 5500 OVERTON RIDGE BLVD STE 228
Second Line :
City : FORT WORTH
State : TX
Zip : 76132-3281
Country : US
Telephone Number : 817-259-1255
Fax Number : 817-764-9008
Provider Business Practice Location Address
First Line : 5500 OVERTON RIDGE BLVD STE 228
Second Line :
City : FORT WORTH
State : TX
Zip : 76132-3281
Country : US
Telephone Number : 817-259-1255
Fax Number : 817-764-9008
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/22/2006
Last Update Date : 10/25/2021

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Directions to “ LISA ELAINE MOCEK PT” Practice Location

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